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General Surgery

Best Papers in General Surgery

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Upper Gastrointestinal Tract24 Mar 2025

Navigation system improves robotic gastrectomy outcomes for novices

A vascular navigation system significantly enhances robotic distal gastrectomy for novice surgeons, according to a study involving 49 patients. The navigation group showed reduced dissection times (179.85 vs. 204.87 minutes) and increased lymph node retrieval (41.81 vs. 30.96). Additionally, the system contributed to lower C-reactive…

Ann Surg Oncol23 Mar 2025

Detection of mutant KRAS ctDNA predicts metastatic risk in pancreatic cancer.

In a cohort study of 785 patients with pancreatic ductal adenocarcinoma, the presence of mutant KRAS circulating tumor DNA (ctDNA) was linked to higher metastatic risk and poorer survival outcomes. Out of those tested, 104 showed plasma MKRAS positivity, correlating with increased likelihood of metastatic…

Perspectives, Opinions and Curiosities23 Mar 2025

Simulation-based education enhances surgical training transitions

Effective simulation-based education interventions are essential for addressing risks associated with transitional phases in surgical careers. These programs, developed by the American College of Surgeons, focus on key transitions—from medical school to residency and into practice—promoting cognitive, technical, and non-technical skills. Emphasizing competency and mastery-based…

JAMA Netw Open23 Mar 2025

Surgical residents face significant financial challenges for childcare.

A study of 295 U.S. surgical residency programs indicates that 98.3% demonstrated negative net income after accounting for living expenses and childcare costs. This trend persisted across various child age groups and regions, with the West exhibiting the steepest losses averaging -$18,852. The findings reveal…

Int J Surg23 Mar 2025

Large language models can improve surgical patient education

A multicenter analysis revealed that ChatGPT-4o effectively enhances patient education before and after surgery. Evaluating audio responses to frequently asked questions, the model achieved an average accuracy score of 4.12/5 and a relevance score of 4.46/5. Postoperative responses were notably more accurate and less harmful…

J Gastrointest Cancer23 Mar 2025

Thermal ablation shows comparable efficacy with better safety for colorectal liver metastases.

A multi-center study of 303 patients with colorectal liver metastases revealed no significant difference in early recurrence patterns after resection versus thermal ablation. Both treatments showed similar 6-month recurrence-free survival rates; however, thermal ablation demonstrated a lower incidence of serious complications and shorter hospitalization. Key…

Ann Surg22 Mar 2025

Improved surgical performance lowers risk of delayed gastric emptying

A study analyzing 192 robotic gastro-enterostomy procedures found that enhanced surgical performance, assessed via objective structured assessment of technical skills (OSATS), correlates with a reduced incidence of delayed gastric emptying (DGE). DGE occurred in 21.9% of patients, with an OSATS score above 25 associated with…

Br J Surg22 Mar 2025

Structured preoperative briefings significantly enhance surgical training outcomes

Findings reveal that implementing structured preoperative educational briefings markedly improves surgical education and trainee performance metrics. A systematic review identified 20 studies demonstrating 93 instances of statistically significant improvements post-briefing implementation. The new 'goals, autonomy, preparation, and strategy' (GAPS) framework emerged from thematic analysis, guiding…

JAMA Surg22 Mar 2025

ICG-guided lymphadenectomy improves survival in gastric cancer

A study involving 459 gastric cancer patients showed that indocyanine green (ICG)-guided lymphadenectomy significantly enhanced survival outcomes after neoadjuvant chemotherapy. Patients in the ICG group had a higher number of lymph nodes harvested and demonstrated improved three-year overall survival (78.6% vs 66.6%) and recurrence-free survival…

Int J Surg22 Mar 2025

Guidelines established for managing high-risk acute cholecystitis patients

An international Delphi consensus study outlines management strategies for high-surgical risk patients with acute cholecystitis. Early laparoscopic cholecystectomy is preferred for those who fail conservative treatment. For severe cases, percutaneous cholecystostomy is recommended to alleviate symptoms quickly. The study emphasizes the importance of assessing surgical…